Stakeholder Perspective on Opioid Stewardship After Prostatectomy: Evaluating Barriers and Facilitators From the Pennsylvania Urology Regional Collaborative

To evaluate existing practice patterns and potential barriers to implementing opioid stewardship protocols after robot-assisted prostatectomies among providers in the Pennsylvania Urology Regional Collaborative. The Pennsylvania Urology Regional Collaborative (PURC) is a voluntary quality improvemen...

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Published inUrology (Ridgewood, N.J.) Vol. 145; pp. 120 - 126
Main Authors Lee, Daniel J., Talwar, Ruchika, Ding, James, Chandrasekar, Thenappan, Syed, Kaynaat, Fonshell, Claudette, Danella, John, Ginzburg, Serge, Lanchoney, Thomas, Tomaszewski, Jeffrey, Trabulsi, Edouard, Reese, Adam, Smaldone, Marc, Uzzo, Robert, Raman, Jay D., Guzzo, Thomas J.
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LanguageEnglish
Published United States Elsevier Inc 01.11.2020
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Abstract To evaluate existing practice patterns and potential barriers to implementing opioid stewardship protocols after robot-assisted prostatectomies among providers in the Pennsylvania Urology Regional Collaborative. The Pennsylvania Urology Regional Collaborative (PURC) is a voluntary quality improvement initiative of 11 academic and community urology practices in Pennsylvania and New Jersey representing 97 urologists. PURC distributed a web-based survey of 24 questions, with 74 respondents, including 56 attendings, 11 residents, and 7 advanced practice providers. More pills were prescribed if there was a default number of pills from the electronic health record (median 30) then if the number of pills was manually placed (P = .01). Only 8% discussed how to dispose of opioids with their patients, and less than a third of respondents discussed postoperative pain expectations or risks of opioid use. Patient level risk factors were often not reviewed, as 42% did not ask about previous opioid exposure. This study revealed extensive knowledge disparities among providers about opioid stewardship and significant gaps in the evidence-to-practice continuum of care. In the next year, PURC will be implementing targeted interventions to augment provider education, establish clear pathways for opioid disposal, improve utilization of known resources and implement opioid reduction protocols in all participating sites.
AbstractList To evaluate existing practice patterns and potential barriers to implementing opioid stewardship protocols after robot-assisted prostatectomies among providers in the Pennsylvania Urology Regional Collaborative. The Pennsylvania Urology Regional Collaborative (PURC) is a voluntary quality improvement initiative of 11 academic and community urology practices in Pennsylvania and New Jersey representing 97 urologists. PURC distributed a web-based survey of 24 questions, with 74 respondents, including 56 attendings, 11 residents, and 7 advanced practice providers. More pills were prescribed if there was a default number of pills from the electronic health record (median 30) then if the number of pills was manually placed (P = .01). Only 8% discussed how to dispose of opioids with their patients, and less than a third of respondents discussed postoperative pain expectations or risks of opioid use. Patient level risk factors were often not reviewed, as 42% did not ask about previous opioid exposure. This study revealed extensive knowledge disparities among providers about opioid stewardship and significant gaps in the evidence-to-practice continuum of care. In the next year, PURC will be implementing targeted interventions to augment provider education, establish clear pathways for opioid disposal, improve utilization of known resources and implement opioid reduction protocols in all participating sites.
OBJECTIVETo evaluate existing practice patterns and potential barriers to implementing opioid stewardship protocols after robot-assisted prostatectomies among providers in the Pennsylvania Urology Regional Collaborative. METHODSThe Pennsylvania Urology Regional Collaborative (PURC) is a voluntary quality improvement initiative of 11 academic and community urology practices in Pennsylvania and New Jersey representing 97 urologists. PURC distributed a web-based survey of 24 questions, with 74 respondents, including 56 attendings, 11 residents, and 7 advanced practice providers. RESULTSMore pills were prescribed if there was a default number of pills from the electronic health record (median 30) then if the number of pills was manually placed (P = .01). Only 8% discussed how to dispose of opioids with their patients, and less than a third of respondents discussed postoperative pain expectations or risks of opioid use. Patient level risk factors were often not reviewed, as 42% did not ask about previous opioid exposure. CONCLUSIONThis study revealed extensive knowledge disparities among providers about opioid stewardship and significant gaps in the evidence-to-practice continuum of care. In the next year, PURC will be implementing targeted interventions to augment provider education, establish clear pathways for opioid disposal, improve utilization of known resources and implement opioid reduction protocols in all participating sites.
Author Uzzo, Robert
Chandrasekar, Thenappan
Reese, Adam
Talwar, Ruchika
Syed, Kaynaat
Smaldone, Marc
Ginzburg, Serge
Lee, Daniel J.
Raman, Jay D.
Trabulsi, Edouard
Fonshell, Claudette
Guzzo, Thomas J.
Tomaszewski, Jeffrey
Danella, John
Lanchoney, Thomas
Ding, James
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Snippet To evaluate existing practice patterns and potential barriers to implementing opioid stewardship protocols after robot-assisted prostatectomies among providers...
OBJECTIVETo evaluate existing practice patterns and potential barriers to implementing opioid stewardship protocols after robot-assisted prostatectomies among...
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SubjectTerms Analgesics, Opioid - adverse effects
Clinical Competence - statistics & numerical data
Humans
Male
Opioid-Related Disorders - etiology
Opioid-Related Disorders - prevention & control
Pain Management - methods
Pain, Postoperative - drug therapy
Pain, Postoperative - etiology
Pennsylvania
Practice Patterns, Physicians' - organization & administration
Practice Patterns, Physicians' - statistics & numerical data
Prostatectomy - adverse effects
Prostatic Neoplasms - surgery
Quality Improvement
Stakeholder Participation
Surgeons - statistics & numerical data
Surveys and Questionnaires - statistics & numerical data
Urologists - statistics & numerical data
Title Stakeholder Perspective on Opioid Stewardship After Prostatectomy: Evaluating Barriers and Facilitators From the Pennsylvania Urology Regional Collaborative
URI https://dx.doi.org/10.1016/j.urology.2020.05.096
https://www.ncbi.nlm.nih.gov/pubmed/32711014
https://search.proquest.com/docview/2427293971
Volume 145
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